The following Stress Assessment is designed to help you quickly evaluate five important
aspects of your stress. The 211 questions cover:
A. Stressors at Work and in your Personal Life.
B. Close Relationships
C. Health Conditions
D. Your Signs and Symptoms of Stress.
E. The Effectiveness of your current Coping skills and Resources.

You can complete the Assessment and use the information to help guide you in your objective
to reduce the stress in your life. Then, you will be given the option to request Stress Less
to provide you with a custom designed program based on your scores and personal background
information.

A. STRESSORS

The following is a list of situations that many people find stressful. Please note those
situations that apply to you over the last six months or that you anticipate will apply
to you in the coming year. For each item that applies to you, press the button next to
the level of stress coping that you believe most accurately describes how effectively
you are coping with each stressor.

- Strained
Frequent difficulty in coping, a sense
of overwhelm or feeling drained,
persistent feelings of anxiety, anger,
irritability, helplessness, worry,
gloom, some impairment in functioning
at work or personal life.

- Balanced
Effective and relatively stable
functioning at work and/or personal
life. Occasional distressing feelings
which are appropriate and minimally
disturbing or disruptive.

54. What is the total number of times you exercise each day or week or month? (use the term from your answer to the previous question)

55. Each time you exercise, how long do you typically exercise for?

56. Do you smoke?

No

Yes

57. How often do you smoke? (please only choose one answer)

58. What is the total number of cigarettes you smoke each day or week or month? (use the term from your answer to the previous question)

59. Do you drink alcohol?

No

Yes

60. How often do you drink alcohol? (please only choose one answer)

61. What is the total number of drinks you consume each day or week or month? (use the term from your answer to the previous question)

62. Do you use recreational drugs (marijuana, cocaine, ecstasy)?

No

Yes

63. If yes, how frequently do you use these drugs? (please only choose one answer)

The next two questions will ask you about your height. The first question will ask for the "feet portion" of your height, and the second question will ask for the "inches portion" of your height. For example: If a person was 5 feet & 7 inches tall, that person would answer 5 feet for the first question and 7 inches for the second question.

64. How many feet tall are you?

65. How many additional inches tall are you?

66. Please type your weight (in pounds) in the box to the right.

D. SIGNS AND SYMPTOMS OF STRESS

The following is a list of Physical, Mental, Emotional and Behavioral symptoms of Stress. If a symptom applies to you over the past 6 months or you anticipate the symptom occuring in the coming year, please rate the severity of the symptom you have experienced or anticipate experiencing on the 4 point scale next to the item. Please rate every item.

I am able to change rigid and absolute stress inducing beliefs into more functional beliefs such as "I can be happy even if others disapprove of me", "the world doesn't have to meet my wishes all the time", and "I don't have to be perfect to be worthwhile."

1 2 3 4

210.Humor

I do not take myself too seriously and use humor to balance life's frustrations